Indonesia has the third-highest burden of TB in the world; and in Papua the rate is trending upward, which may be due to high levels of migration from other areas of the country and the association of TB with HIV. Advances in screening and access also mean that there are more known cases in comparison to other areas where cases may remain undetected and under-reported.

The TB clinic run by Community Public Health and Malaria Control Department with technical assistance from International SOS collaborates with the nearby government-run Puskesmas by sharing resources, knowledge and skills in a way that’s unusual for Indonesia. “An obvious contribution of the TB program is the fact that a consistent and persistent treatment regimen is now readily accessible for communities in the Mimika regency”, says Arief Latif. “But in addition we are helping the medical community further develop and improve medicines and methods to combat this disease.” To this end, a three-way collaboration is already yielding results, with the company providing the funding, while qualified staff and facilities are provided by International SOS and research expertise by Menzies University in Australia. “The project has given us access to research facilities we would not otherwise have had, enabling us better to understand resistance and immunity patterns in this remote area”, says Dr Strohkorb. “Based on

the data we can now offer better treatment of drug- resistant strains of several diseases using new drugs under special licence from the Indonesian government.”

Inclusive approach Learning is also being shared across the new migrant population. Papuans make up a third of the workforce, with 5% being expatriate workers and the rest Indonesians from other parts of the country. “Due to the remoteness of the area in which we operate there’s the problem of attracting qualified medical professionals such as doctors, nurses, midwives and paramedics”, says Dr Strohkorb. To ensure knowledge and skills are effectively transferred most expatriates working at Freeport Indonesia are paired as technical advisor to an Indonesian counterpart. “The goal eventually is to ensure that the role itself is transferred to the Indonesian employee”, explains Arief Latif. Some positions have already been permanently filled by an Indonesian, including the manager of the community development program and the vice president for social local development.

“This is another form of empowering the community in the longer term because a community that’s better educated is better able to take care of itself”, adds Dr Bethea. “We believe strongly that an inclusive approach is the most beneficial because it brings together all available resources jointly to tackle the most pressing issues faced by this newly formed community.” ■